Mind Pump: Raw Fitness Truth - 1650: How to Know When You Need a Physical Therapist

Episode Date: September 27, 2021

In this episode Sal, Adam & Justin speak with Palak Shah, co-founder and head of clinical services for Luna, a revolutionary at-home physical therapy provider that is disrupting the industry. What is physical therapy and what is its goal? (2:27) Why not every physical therapist (PT) can treat an acute patient. (6:55) Busting the myth that your joints have a shelf life. (8:52) The value of finding insight into your own self. (12:03) How movement is a skill. (13:53) The importance for PTs to empower their patients. (16:15) Are DPTs (Doctor of Physical Therapy) better than PTs? (19:49) How has physical therapy evolved over the years? (26:13) Why do 70% of patients stop their physical therapy before completion? (28:26) What is home-based therapy? (30:51) Will my insurance cover the cost? (34:15) What types of services does Luna provide? (38:16) Luna Physical Therapy, bringing good quality care outside the four walls of a clinic. (39:25) Can you effectively treat someone at home without the fancy equipment? (40:47) How does a PT become a Luna practitioner? (44:06) How does Luna loosen the burden of documentation for the PT? (45:59) How innovation creates disruption. (50:38) Can my child be seen by a Luna practitioner? (52:18) What type of people should seek physical therapy? (55:04) How important is therapy post-pregnancy? (58:00) Will the fitness enthusiast benefit from physical therapy? (1:00:04) Did Luna find Palak, or did she find Luna? (1:01:25) Related Links/Products Mentioned September Promotion: MAPS Performance and MAPS Suspension 50% off!   **Promo code “SEPTEMBER50” at checkout** Luna Physical Therapy Visit Paleo Valley for an exclusive offer for Mind Pump listeners! **Promo code “Mindpump15” at checkout for 15% discount** Mind Pump #1622: Nine Signs Your Trainer Sucks Luna Resources What is the Best Form of Exercise During Pregnancy? - Mind Pump Blog Mind Pump Podcast – YouTube Mind Pump Free Resources

If you want to pump your body and expand your mind, there's only one place to go. Mite, op, mite, op with your hosts. Salda Stefano, Adam Schaefer, and Justin Andrews. You just found the world's number one fitness health and entertainment podcast. This is Mind Pup, right? In today's episode, we interview Pollock Shaw. She's the co-founder of Luna Physical Therapy Services, they actually come to your home, and she's the head of clinical services there.

Now in this episode, we talk all about physical therapy. Like, how do you know when you need it? What's the value of physical therapy? What should you get out of it? And the new disrupting technology from Luna. So really cool episode. In fact, this company blew us away so much disrupting technology from Luna. So really cool episode. In fact, this company blew us away so much that Mind Pump

actually became an early investor in this company. So it's really, really interesting episode, especially for those of you with pain, with mobility issues, performance issues, physical therapists can bring your tremendous value and now they can come right to your door and it's all covered by insurance. By the way, if you're interested in this particular service,

head over to getluna.com, again, it's getluna.com, and this is for patients and for physical therapists who may want to work at Luna as well, because they're always looking for good PT's. Now this episode is brought to you by one of our sponsors, Paleo Valley. They make incredible products that are paleo friendly. One of my favorites is their bone broth protein.

It's one of the most unprocessed protein powders that I've ever found in my entire life. There's literally nothing in there except bone broth. That's it. There's no flavors, no nothing. Just bone broth, it's one of my favorite proteins and it's the easiest protein I've ever taken in terms of digestibility

Go check them out. They have other products. They have organ complex for example if you want to get all the benefits of eating organ meats But don't like the taste check out the organ complex and of course there's a lot more head over to paleo valley dot com forward slash mind pump again. That's paleo valleyi.com forward slash mine pump. Use the code mine pump 15, that's mine pump 15 for 15% off your first order. Also, there's only four days left for our 50% off sale, maps, performance, and maps suspension. If you're interested, head over to maps fitness products.com. Just use the code September 50, that September 50 with no space for that discount. Let's start with just physical therapy and just define it. Like what is physical therapy?

What's the goal of physical therapy? Great question, so fundamentally physical therapy is defined as therapists who are movement specialists. So physical therapy is a program that is covered by insurance. Of course, it's a healthcare provision to ensure that you have received care to recover and bring you back to functional activity. However, the definition of physical therapy, physical therapists is changing. So physical therapists, you would go to a physical therapist if you

are injured, if you're hurt, you need to get better from something, and most of the time you procrastinate on that because you don't know if you are hurt enough to actually go to physical therapy. So physical therapists, if you think about them as movement specialists, musculoskeletal injuries is one of the most common healthcare expenditures and the largest healthcare expenditures. So physical therapy truly can be taken a look as primary therapy truly can be taken a look as primary care, can be taken a look as rehabilitative, post rehabilitative, pre rehabilitative, so there are a lot of times when physical therapy

is what a patient needs or what a person needs. And I think that definition's not very clear to it. Well does it, now okay, so let's say somebody goes to a physical therapist because they've injured themselves, is the goal to get them to move without pain or is the goal to get them to move the way they did before they hurt themselves?

Cause those are two different things, right? Absolutely. I think that the most important thing is to understand as a therapist, what is the right movement? What is the right ability for your muscles to recover? Why you're having pain? Is it because you're not moving right? Or are you moving less?

Are you moving more? And hence an assessment, a thorough assessment of understanding what is the problem? What is the cause? Before you actually jump right into the pain area, is the most important thing. So as a physical therapist, we're never treating the pain. We're treating the cause.

And identifying the cause is why we have an initial evaluation. The first visit, a lot of our patients are telling us, OK, but we didn't really do any treatment today. And that's because there's some science behind this. We're actually spending all this time just trying to understand, do we need to move you through that pain or do we need to actually

train something else so that as soon as you train something else, your pain is actually going to be better by not doing anything where the pain area was. You know, you just... You just hit on something that we tell our audience how to identify a good personal trainer or a bad one. And that is, if the first session is mostly assessing and no working out, you've probably got a bad one. And that is if the first session is mostly assessing and no working out, you've probably got a good trainer. If your trainer, the first day you see them,

gets you into a workout right away, you know you probably have a bad trainer. Yeah, and what you were saying, you know, I just, I'm gonna kind of close that loop a little bit is, you know, sometimes your knee pain, because I think a lot of people, for example, I'll just use the knee, your knee hurts, and so you think something's people, for example, I'll just use the knee, your knee hurts, and so you think something's wrong with my knee.

It's my knee that hurts, therefore it's my knee that needs to get fixed. Whereas oftentimes, it has nothing to do with the knee, it has a lot to do with, I don't know, the ankle or the foot or the hip, or maybe the ankle on the other side of the body. In other words, the root cause of the knee pain is not the knee itself. And I think that's what you mean by not treating the pain, but rather, try treating the cause. Absolutely, and I think knee pain, the second largest condition,

that physical therapy treats, right? I mean, if you're having pain inside your knee or underneath your kneecap, like, why is it getting loaded more? Like, what do we do when we are overworked? You know, we crash. We kind of are like, this is too much for me or get overwhelmed.

And that's exactly what happens when we hurt. Our knee has loaded, has been loaded more than it could handle. And we just got to figure out who's not doing the job. Let's go train that muscle. So, knee pain would be like your number one in terms of people coming in for number two, you said two. So is low back pain number one?

Absolutely. So lower back pain. And of course, it depends, even in physical therapy, we're trying to improve awareness. Patients don't know when to come in. And so yes, but based on analysis, lower back is definitely number one, the highest musculoskeletal condition treated and prevalence wise to and knee pain definitely goes second in the active population that we're looking at. Now what percentage would you attribute the rehab that you have to do is related to an

acute injury versus somebody who has either chronic pain for years and then showed up or injured themselves because of poor movement patterns. And that's why they're there. Yes. Oh my gosh. I have percentage wise. I think I don't really have that on the top of my head. But what's most important is there's specialty of these physical therapists.

So not every PT can treat an acute patient. And acute injuries can be lots of different types. Like, did you actually fall and then your knee started hurting? Yeah. Or if you jammed your knee against something and that's why your knee started hurting versus, well, you just overloaded your knee doing really heavy weight lifts and that loaded your knee.

So I think there's that importance of understanding. But acute care and physical therapy can be after an acute injury. And there's so much evidence that when we see our patients within 15 days or 20 days of being injured, their, you know, ability to recover is significantly high. And that's the reason why today when you go to an urgent care for a low back pain, oh my gosh, I can't even straighten up. We're really working as an industry and physical therapy to tell those urgent care physicians don't send them to your PCP. Please send them to physical therapy.

You're a doctor, you can refer your patients. Let's not get them into this chain of being going from one doctor to another until they really are coming back to physical therapy when it's evidence-based that it benefits you. Yeah, the example I used to get, so I used to work a lot with physical therapists and the examples I would give to kind of illustrate where we're saying it's like, and this is a simple example, it's funny, but it's kind of true. It's like you're banging your

head against the wall and then you go to the doctor and you're like, my head hurts. And they said, well, here's some ibuprofen, whereas somebody who's looking at the root cause is going to look and say, okay, let's stop banging your head against the wall. And that's probably what's going to solve the problems. You don't have to keep masking this particular issue. Another thing that's very interesting is, and this isn't so much of an issue now, but with older generations, I worked a lot with people in advanced age. And a lot of times, if you go back decades, when people had pain, it was because of overwork,

hard labor, nowadays pain comes from inactivity often, right, or poor movement patterns. And I think there's this kind of widely believed idea, which is a myth, that joints have a shelf life. If you use a joint too much, if you move it more, it's just gonna get worse, which isn't necessarily much, if you move it more, it's just going to get worse, which isn't necessarily true. If you move it right, it actually gets healthier and it has even more longevity.

Is this an issue you ever have to talk with patients about? All the time. And in fact, I find two opportunities in what you said, Saul. First was about the first is about this longevity of using your joints, right? When you are using your joints, but if you're using it, right,

you have the right muscle balance and your body is able to handle that joint stress because you're training your body to do more. So if you're training your body to do more, you have the right muscle balance and you're doing an activity that's not unrealistic. Like, of course, you know, you don't really wanna be doing something that's unrealistic for your body. So if you're doing an activity that's not unrealistic. Like, of course, you don't really want to be doing something that's unrealistic for your body.

So if you're doing all of that, more activity is good, but you are wearing down when it's high impact. So there's a difference between impact exercises or stabilization exercises. So what kind of exercise are you overdoing can be detrimental to your joints. So definitely a propria to the person. Absolutely. And appropriate to your joints. Right. So definitely that's a concept. To the person. Absolutely. And appropriate to your cause of training. Right. So are you doing this?

So you wouldn't want to do heavy weight lifts, which is burst of movements, versus a therean sexercises or endurance exercises that are high-repetitive, but are not high impact. So what kind of exercises are you doing to actually affect your joints is what I think every everybody can benefit from knowing? Like am I doing box jumps that are you know impact exercises and doing them three sets of 15 or are we doing five sets of five? You just hit one of our sweet spots. We love to just do we hate box jumps with trainers. That's like one of the number one thing.

Nobody does a ride. It's like, it's like a, and the wrong people are doing it. They have, they have my lady who's 55 years old and 30 pounds overweight and she's doing 15 jump boxes. No, exactly. Terrible person to be doing that. Very true.

But so I actually wanted to also hit this other thing which you mentioned, which is we come from people who've been very active in our hurting to come, you know, from pain coming from inactivity. But then we have this other category of people. Those are our weakened warriors, right? We're in active the entire week and we're like, okay, we're going to be out this entire weekend, either hiking uphill or doing activities or doing two days in a row of personal training. I think that's another area where education becomes really

important for our patients. So we all the time are addressing lifestyle, understanding where they come from and we're going to get into Luna in a little bit, but that's exactly where having the opportunity to be in your patient's environment as compared to a patient actually coming into a clinic environment tells a therapist so much more to help them in a better way. Yeah, I have a question about pain. How does that conversation look as a patient comes in? How can you actually talk them through in terms of defining what type of pain it is and then be able to bring that to a point of where they can understand, is this really something

detrimental or is this really something detrimental, or is this something, you know, we can kind of work through? Sure. I think that we, as therapists, during our initial evaluation, try to stay away from too much of a pain conversation. What we're actually trying to give them is insight into their own self. So when we do an evaluation, we're talking about, yeah, where are you coming from? What was your prior level of function? Did this really start hurting five days ago or was

this something that's been going on for three years? And if somebody is coming in with pain being there for three years, they're more focused on things that they cannot do because of that pain. As compared to get my pain away, they're talking more about, I can't run. I have to give up on lifting up my kids, or they're talking about things they're not doing. And that's where that mind psychology comes. And what is our patient's end goal? And this is not every therapist, right?

And even for therapists, this is an important question. Is at the end of our assessment, are we addressing their pain, or are we addressing what they want to really get back to and working it towards that? Worses okay, let's fix your pain. You got to do these five exercises that take care of pain Worses if you want to get back to lifting your kids without pain or putting them in the car seat without pain Let's talk about how you do that and figure out what your plan should be. Yeah, it's such a great approach And this is how we found success as trainers

was focusing on those types of things, working on the person rather than necessarily the problem. You know, earlier you were talking about weekend warriors and I'd love your commentary on this or your opinion. I think fundamentally people misunderstand, exercise, they don't realize that movement is a skill. In other words, someone says, I wanna start working out. Lemigo lace up my running shoes, it go running.

And they haven't really run since they were 10, so they go put their shoes on. And what they don't do is think to themselves, I never run, I probably don't know how to run anymore. They don't think that, they think, I'm gonna go run until I get tired. Versus somebody who understands this is a skill. Let me go outside and practice running and get good at it and get the skill of it before I go run to fatigue and get tired. Is this a conversation you have to have with people?

Yes, I think it's a really good conversation. And most importantly, again, it comes from understanding the person, right? Are are they if a patient would be like I exercise a lot. I just go out running. I run like you know five times a week I go out every morning and I run and even if they're not running to fatigue and they're running 15 20 30 minutes They're doing it every day, but they forget the point that Exercising is slightly different from running because running you're exercising your heart, but are you actually exercising all the areas that

should help you in running so you don't hurt your joints? So what is the purpose of running? Running is helping your heart stay fit. Running is helping your muscles stay warm, but if you're not running right, then you're tightening some place, you're loosening some place, and that could lead to increased joint stresses and can cause pain So yes, I think communicating with our patients that You know, we're never actually try to tell them to stop doing something

So if they are liking running and they're not hurting with running Please keep up because otherwise we lose them right there You know, you don't want to lose your patients by telling them not to do something that they're having fun doing and they're not hurting doing. I'm not gonna say don't do that. Talk about what a challenge that is. One of the hardest things as a trainer is like, taking, knowing that you,

oh, this would be better for us, but this is something they love to do and they've been doing consistently that fine dance that therapists and trainers have to be able to make. It's like getting them what they want, what they should do. All the time.

Now, and we will get into more specifics about how the industry is being disrupted and where you're coming from. But I do want to talk about the clinical setting of physical therapy as it is now, or as I should say, as it is in the mainstream. There's a couple issues that I've had with it in the past, which you've already actually addressed.

Oftentimes, I feel like, and I've had physical therapists that were phenomenal, and I've had some experiences that were like, what's going on. They're not focusing, like you said, on the person, on me. And then I've had these experiences where they'll say, do these exercises and they're gone. And I'm doing this movement on my own, or I have some, you know,

kinesiology student watching me, example is also there's also five other people who are doing exercises I know as a trainer when I take my eyes off a client for 10 seconds they don't have the awareness yeah they don't have the aware in fact this was a selling point you know I'll be honest I used to do this thing with people where I do an assessment I'd have them do a basic cable row and I would put them in proper position. I'd, you know, have the scapula retract and depress and they'd be like, oh my gosh, this feels we're good.

They would do two or three reps with me helping them. I'd take my hands off, they'd do two or three reps on their own and I'd show them on my phone when I'd film it and I'd say, do you see how your form changed? And I literally left you alone for two seconds. And so when I saw this in that setting, I was like, this can't be good. Is this something that's gonna be remedied

or is this an issue that is being discussed? Of course, it's always discussed. And one of the things that as a physical therapist, we keep in mind is empowering our patients, right? Our goal is to make a patient feel, they can actually do it without us watching over them all the time. That is our goal because we can't keep them in physical therapy all the time. They're not going to be covered by insurance and

be able to see them for six months or one year and we don't have that privilege to do that. So our conversations with our patients are about making them talk about what they're feeling. Okay, can you tell me what you're feeling? How does this feel different from what you just did? And one really good example is about how we stand. Like when we're standing, is there weight on our entire foot or just the back of your foot or in the front of your foot? So having the patient actually or a client actually talk about what are they feeling?

Let's maintain that loading it to the level that those small muscles that actually contribute in stabilization are able to handle. So there are larger muscles and there are smaller muscles. The smaller muscles are more, you know, filamented and then they have more stabilization role, whereas the larger muscles are actually the levers and they're actually doing the movement. So they need to work together. And if those stabilization muscles, you don't have the awareness for it, then you're losing that form. So as a therapist, what we're actually telling them is to focus on,

okay, can you feel how this feels to retract your shoulder? And we don't have to really retract too much, but just a little bit to set it on your body and on your ribcage. And then you need to maintain this. Can you do this with a yellow TheraVand or a yellow tube? And then, okay, I think you did it well. And then we do another set with a red tube. And we do another set with a green tube.

Getting them to connect. Yes. And then they will feel, oh my gosh, this green tube feels very hard. And I can only hold that scapula for five counts. And so as a trainer or as a therapist, I would say, okay, let's take to red because I want your brain to train how to maintain this and do 15 of those with the red in a correct way before we move on to the green. So that's a progression as a therapist.

We would go through a while. The patient develops independence because we need them to do this at home every single day so that they retrain their brain. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right experiences enough times that there'll be this one clinic that will have, you know, four DPTs and then the rest all PT's. And then there'll be one where there's only one DPT and then there's all PTAs. And there are those one that's all DPTs. Like, what a great question. So our DPTs better than PT's, right? So there's two ways of looking at that. Physical therapists had a master's degree for the longest time. So there are definitions are PT's. And in the last five or so years,

we've now started having DPT programs, which is you get a doctorate of physical therapy in the first three years of training. So they are the newer generation of PT's who are all receiving doctorates. There are no more just PT programs. So one way of looking at it is I have a PT title. I don't have my DPT, but I have 15 years of work experience.

And here we have another DPT who has five years of work experience because that's the degree you receive when you are at a school. However, there is a curriculum change, which is understanding red flags, understanding when you should be referring patients back to the physicians, understanding pharmacology, understanding medical management. That has been formally added to physical therapy training,

very recently, which has enabled the doctorate title for physical therapists. That also comes along with a transition in direct access, which we're going to talk in a second. So, now coming back to your question about the distribution in different ways. Yeah, like why? Yeah. I think it depends on who suits that clinic environment.

I think every clinic, every location comes with its motive. Are we treating and you know demographics that they're treating, right? Are we mainly treating patients from sports injuries? What kind of relationships I have with my physicians and my surgeons? Am I treating mainly pelvic floor physical therapy? Am I treating vestibular rehab? I'm dizzy and I kind of can't even drive to my gym. What kind of conditioning are we treating? What kind of therapist training do we have? That defines the different specialties between DPPTs and PTs that have that experience in those fields.

Difference between PTAs and PTs, I think that, again, I think it's a scaling question. Just the way we have teachers assistants, we have teachers assistants because the teacher can do everything, but there are certain things that are safe and well-trained and well-educated physical therapy assistants can handle, which is continuum of treatment. So the difference between a physical therapist and a physical therapy assistant is physical therapy assistants don't change the treatment plan. Yeah. They will follow the treatment plan established by a physical therapist. Okay. Now how many times in that situation though is the you know owner of the clinic making that decision

based off of the demographics that you talked about versus the monetary reasons for them. Because I imagine business model D.P.T.''s, PTAs, and Kinesis, you know, students or whatever, are all getting different pays. And is it a common practice for some of these clinics to, you know, maybe less about serving the client and more about serving my pocketbook of making sure that we make the most profits off of this? Is that common? It is common.

It is common, but there are a lot of regulatory, a lot of compliance rules established by Medicare and in these insurance payers that decrease poor practices. I have worked in a clinic where I saw my patient for 20 minutes and I had my next patient in 20 minutes, but that patient would continue to do exercises with a physical therapy aid, right? So are you in that environment or then I went on to Stanford where I was seeing my patients for 30 to 45 minutes and billing only for times that I was providing care for my patients. Quality was at its peak at Stanford. We brought that to Luna, which is one on one time

with your physical therapist in your home for 45 to 55 minute sessions and there are no physical therapy assistants, no aids. So absolutely, does that decrease the number of time you actually need to go into PT because your therapist is monitoring you for whole session? That's a good question. You know, maybe you recover with lesser number of visits

and you recover. Of course, that's no different than if you saw me with 20 years experience as a personal trainer and then I have my kid who's coming through school right now and maybe I just do the first session with you and then I say, here, now my kid's going to take you the rest of the way through. And even if he's a smart kid and the years of experience that I have, I know I could get that client to the result or their goal faster than. Sure, and I actually think that a lot of the new grads come in with a lot of expertise, a lot of clarity in their approach

because there's definitely upkeep in the curriculum and the training and the kind of internships and exposure that we have. So I'm not really thinking that there is a, I'm not always just saying that an experience PT is always better than a DPT or of newly grad, but I do think that right training is so key. And a therapist is responsible for the care of the patient, even if they're handing it

off to a physical therapy assistant. So coming back to your point about when the clinic owners are making this a business over, you know, over actually knowing what is right for our patients, a therapist determines that. If I think that this is scared that somebody with chronic pain, for example, we know this has been going on for a long time, we're going to need to condition this patient to actually, before I change something, let's have a physical therapy assistant continuous program who can very, it was very qualified to treat this patient, let them do that and as soon as the physical therapy

assistance sees a need for transition, they're gonna bring them back to a physical therapist, update the program and move forward. So is that actually a compromise, not always, but if you're making it a business, then that is a problem. So definitely as a patient, I would wanna ask, am I actually getting better here? That's the question. I wouldn't really challenge it otherwise.

Now, you talked about updates to the curriculum and DPTs and how has physical therapy evolved like over the years and what kind of other modalities and other methods have been brought into therapy? Yeah, I think as a physical therapist, we always want to have a toolbox because we think that not one thing fits everybody. So lots of different approaches, like even corrective exercises or progressive, like progressive corrective exercises,

movement impairments are concepts. So there are lots of different approaches to care. And I think they've all evolved by improved education, improved curriculums, improved continuing education, offerings to us as therapists, absolutely going virtual, going remote, helps you start learning if those are your barriers to learn. So I think that's one.

But there's so many things. How does restrictive blood flow work? And how does I'm not an expert at it? But I would agree. I think that there's so much including cupping and including, you know, resistant, restrictive work, blood flow, and, you know, even utilizing corrective exercises and PRA exercises, how does all of that change your approach? And I think as a therapist, we're using those as stool kids as compared to that is all how I treat.

We love BFR, actually. In fact, I love it for the physical therapy side more than the performance side, which is what is, it's made its way actually into the fitness space as kind of performance. Yeah, a great way to build muscle. But it's got great rehab application. Yeah, and I did, I was not familiar with it as a trainer when I was in the training space. I've found that we found that actually right when we first saw the podcast, very first episode, it was the first new bit of information or science that I brought to the podcast, I was experimenting with it. I had just heard podcast. I was experimenting with that.

I had just heard about, I think they were using it on like hockey players first to rehab them from injury sports injuries. Right. And it's just a great way for a trainer and coach who that makes gets a client from PT. They're now ready to strength train. But then we don't want to load too much yet. So to restrict that way and get similar benefits is loading it heavier was, I thought incredible. It is incredible. When we talked off air off air yesterday we talked about there was an interesting statistic

I wasn't familiar with which is it was like a certain percentage of people stop their therapy after I think it was like three sessions and it was a Lord you remember that percentage what that was? Absolutely so it's pretty eye-opening actually because what we've noted is 70% of patients, actually, when they start physical therapy, they're motivated, but they taper off and 70% of them don't complete their care. They prematurely stop going to the clinic, they don't come back, and fundamentally how things work at a clinic are, I'm going to go in, I'm going to hear, look at the receptionist telling me, what is my schedule and what is the availability of the therapist? Okay, today I have an opening at

7 a.m. in the morning and another day I have an opening at 2 p.m. in the afternoon as a normal human being I'm working full time. I'm not able to accommodate that. So a lot of inconvenience kind of plays into that factor that we've noted That's one concept and then the other approaches also understanding not having a right therapist that educates you on what we are going to do next. And not having that vision built up in their recovery process can also be the demotivator to continue. Yeah, I would imagine there's those roadblocks, right? I got to drive to the place, got to find the sk- that's always an issue. I think another one would be, I had this pain and the pain's kind of gone now.

I'm done. And not realizing that there's more to do because the pain tends to be one of the last signals you get from your body. And there's a lot of stuff you can do before that. Exactly. And that's where I think that therapists' communication becomes so critical.

Like, what are we working towards? Are you able to do that? Are you able to do your tennis swing? Are you able to put your kid in the car seat? Are you able to do the heavy lifting that you wanted to do and telling them how it's going to progress, like laying out the plan for them? And giving them some prognosis, which is conditions like yours take about this much time. And we don't have to see you two times a week for this entire six months, but I would like to see you two times a week for the first four weeks, till you get to know what we're doing. And then let's go down to once a week for another couple months, and then maybe I'll see you once in two weeks for the rest of it.

And that's where I think there's a beautiful way to connect with personal trainers, whether they're returning back to their activities, but they continue to need the insight and the expertise of a therapist. So I recently had a really interesting experience with therapy. So my grandmother had a minor stroke, lost some function on one side. It was recommended that she get a therapist when it was appropriate. And my grandmother, my grandmother's, you know, she's in almost, she's in her 80s and she's old school immigrant Italian. No way in hell would she go to a clinic and work with someone.

There's no way she'd go somewhere. But this therapist came to her house and she was actually very consistent because the therapist showed up, helped her at home and we were all delighted that my grandmother, once or twice a week was doing these exercises, and in no way she would have ever done it if we had to drive her somewhere,

what is home-based therapy? Like what is this, and is this something relatively new? Is it disrupting the space? Well, I'm definitely sure from all our listeners and even from the people I know, so many resonate with that story, where we have had a need, we haven't had the option to actually have physical therapy come home,

but we actually get to experience it. We know how it is something that we need and it's easier to stick to and we're able to get better faster. So it is very disruptive because there hasn't been an option like Luna before, which is outpatient physical therapy at home. And there are a lot of benefits to that. So until today, if we talk a little bit about the history of it, there were home health agencies that are able to see patients right after an acute episode,

where you're able to see your patients at home. But that trend is changing. Luna's bringing out patient physical therapy to patients at home, which is more cost-effective. It's covered by your insurance. And you're able to be seen in your environment, which is absolutely helpful. So yes, I mean, I think that it is disrupting because there isn't an organization like Luna that is doing it at the scale.

Today we're in 19 different states and 32 metro markets across the country. And that's because patients need this. Patients understand the importance of physical therapy, physicians, health systems, doctors, everybody understands the importance of physical therapy. We know that 70% of the patients quit going to the clinics. When we did a major study or a major analysis with one of our health system partners, it was identified that 87% of the people

that actually go to a clinic can be seen at home without compromising their quality of care. So if you can start receiving care sooner, at your home, why procrastinate, why wait to go to a clinic and drop off versus start PT with Luna? Are we seeing a better stick rate with this with people having, I mean, I would have assumed for sure, but what are you, what are you guys saying? Absolutely. So even in terms of adherence to care. So that's a very important metric. We look at it, Luna, which is there and to care. Did you drop off after three or four visits?

Luna's average today is about 12 to 13 visits, which is also very evidence-based. If we are looking at evidence-based care, because we're not really just seeing our patients more, we're seeing our patients more to actually see better completion of care and better outcomes. So when it comes to healthcare, we're looking at all of those things as well, that how is patient engagement, how is the actual technology driving better quality of care? Okay. So here's a big question. I know the answer because I asked you guys earlier, but I did not know this before, and

I was really upset that I didn't because this would have been a huge roadblock. Typically when you get physical therapy, you gotta go to your primary care physician, my knee hurts, then they refer you to physical therapists. Now your insurance... Those options are limited. Yeah, they can, the insurance that approves it, and then you're set, and then you're good.

And so I'm like, okay, well, why would, boy, this is a big problem, because Luna, which is the company that you're representing, which we think is the best in this particular space, they send people to your home, but they're disrupting a market that's largely being clinic based. Why would a primary care physician refer to this, you know, at home thing when they've been working with this?

But what I learned from you guys and correct me if I'm wrong, you don't have to get referred. If you have insurance, you can go straight to Luna and your insurance will approve someone coming right to your house. Yes. So, that is one of the other things that's changing in the PT industry, which is direct access. So, now, with a lot of congressional activity, all 50 states in the country have some sort of direct access ability, which is, for example, the state of California, a patient can be seen

for 12 visits or 45 days without a referral. Wow. Because there is a understanding that physical therapists when being the primary care providers are able to contain most of the injury or support a patient to the best possible, and they're great at recognizing when this patient needs to maybe get an X-ray or needs to be referred back to the primary care physician or to an orthopedic doctor. So that level of training and that level of trust in the healthcare team has come in where direct access is actually now a regulation of state and federal ability.

So to be honest, that is going to be for all of... I mean, we have such a large personal trainer audience. And I know so many times where I'd get a client that was still battling something that I, it was just above my pay grade. I wasn't ready to, at that time in my career, to help that client figure out what was going off their shoulder. They knew they had a problem hurting. I could tell by the way, they moved, they weren't moving properly, but had to address it

and fix it. And if I could send them to a place without having to send them to their, you know, the general practitioner to then refer them, to then go through all of it, to be able to go directly to Luna, and maybe hopefully work with them for four to six weeks to address it, fix it, and now they know that they come back and see me. So, to be clear, now, PT's are being considered primary care in the sense that they can refer, so they're the front line. So let's say I'm at home in that sense, right?

Let's say I'm at home and I'm like, my back hurts, I need to figure this out. I could go to Luna, Luna will send a PT to me who can then assess me and my insurance will cover treatment based on what the PT recommends. Or the PT could say, look, this is something you need to see an orthopod for and they can refer me in that direction.

Yes, and referral in the healthcare system means different. We can't really write a prescription, can send you somewhere, but yes, we are basically identifying if this is within the scope of our practice. So as a licensed therapist, I know what I can treat. So when the moment is where I can treat this, I'm going to tell you to go to your doctor. Wow. So that is ethical practice and it's under our license and we are bound to our licenses. So yes, I mean, there is a lot of trust.

When you go to a doctor, they're going to write a prescription for physical therapy that says low back pain. But is your low back pain coming from a potential disc irritation or is it coming from a facet joint irritation or is this a neuromuscular limitation or a neurological tension? The therapist is determining that and so we're doing like PT diagnosis. We're not really saying you have spondylolystices or you have a disc herniation. A therapist would never do that because those are medical diagnosis, but we know what's causing you the limitation or the restriction in your functional movements and we're treating that. Interesting and covered by insurance

This is the part that blew me away the most the second thing that I think is fascinating is when you go to a clinic We just described kind of what typically happens in a lot of clinic clinics the PT gives you the program and then there's a PTA that kind of watches you and maybe they're watching four different people. So you're spending maybe 15 to 20 minutes with the main physical therapist. When people come to your home like with Luna, is it just you and them and that's it and they stay with you basically the entire time? That is absolutely it. So as you said before, if I have low back pain, I can call

Luna. Luna can send out an experienced skilled therapist who is trained in orthopedics to be your play to, you know, to provide care to you. It's covered by insurance. It'll be a one-on-one 45 to 55 minute session with just your therapist. And of course, you have the Luna technology. So we have an amazing Luna patient app which when the therapist provides exercises you could actually use the workout program in the Luna app. And then if the therapist says do your exercises three times a week, you're actually seeing if your patient did them three times a week or did they do them once a week. So you know what's realistic for your patient. Wow, that's interesting. Now is okay, is this like we more expensive then because if I have someone like that with me for 45 minutes versus

You know two or three people watching, you know 10 people do extras It's got to be a lot more expensive or is there where there are a lot of things that were cut out a lot of middlemen that made up that difference like how does that work? You're setting up for amazing answers that made up that difference. Like, how does that work? You're setting up for amazing answers from me. That's what I would wonder. Yes. This must be so much more expensive. Yes, because the hard to believe truth is it's magical because there is no added cost

to a patient to get care in this manner, to have a therapist in your home, to have an application that monitors you when you're not in PT, to have an application where you can actually chat with your therapist even between your treatment sessions. All of this comes free, but it's basically healthcare, it's great care. Our goal was to actually bring good quality care outside the four walls of a clinic because that improves access. Access is one of the biggest problems in physical therapy. It's not doing an annual visit once a year

with your primary care physician. It's seeing your patient two times a week for six weeks, 12, 15, 20 sessions. Are you actually gonna make that, you know? And so I think it's really, really important that you're able to stick to it. You're able to return to your function and you're not giving up on it.

Yeah, another question is, and I know the answer to this because I know what's, what is typically required for rehab or for correctional exercise, but the average person maybe listening and thinking, I don't have equipment at my home. So how can they possibly help me, you know, when I don't have all these machines or things to work with. Now I know with rehab, it's very, you don't need much, you need bands, maybe body weight and a chair or something like that. Can you effectively treat someone at home without lots of fancy equipment? That's where that statistic about 87% of the patients that go to an outpatient clinic can

benefit from at home. But that doesn't mean that there is no fancy equipment. There is equipment, which actually is something you can do, even when you're not at a gym or when you're not in a PT clinic. So the most important thing is how do our patients get empowered to do something even after physical therapy, right? So if I discharge them, I still want them to keep up with their program. So we're basically therapists are bringing in this entire toolkit.

It has all the assessment tools that they need to do your assessment. It has treatment tools like terabans, there are loops, some proprioception training, materials, but those are portable things. You as a patient, if you're going to a hotel room for work, you're still able to take your things with you. So you're tailoring the program to what a patient needs. A therapist brings in a treatment table, you're not being treated on a bed or on a couch or on the floor, you're actually being treated in a professional workspace on a treatment table. You are receiving infection control practices with COVID that has become super important.

So all of that is done digitally and the way we we kind of put it is the clinic comes home. You're not going to the clinic. So we are maintaining all of those. That's a good point with, that was a very good point with the, with COVID because that's changed, it's changed the environment so significantly that there are probably people who are afraid of going,

especially if they don't think it's necessary. Like, my knee hurts, but it's not super bad. So I don't want to go to the clinic with lots of other people. So I'm assuming that this particular environment is probably only boosted the popularity of in-home services. Am I correct or is it? Well, I would say we've been longer than the COVID. So patients had already started recognizing this benefit. We're moving in this

industry, in this world where everybody wants good quality care while it's convenient. And convenience was never focused on before. However, it is delaying receiving care. So how do we improve access? So Luna started patient care in 2018. And of course, COVID stuck more so like last year. Definitely increase in understanding and need. We've supported so many surgeons who couldn't do elective surgeries and how do we maintain our patients pain levels, how do we maintain their recovery, how do we help them sustain their ability while they're waiting for their surgeries to happen. So definitely a huge uptake.

We've expanded significantly in the Bay Area. We have about 10% of outpatient physical therapists that actually now work for Luna. Wow. Which is huge. That's a lot of hot. Therapists love it. They love the ability to see their patients in the home

and patients absolutely love it because they don't want to delay care if there is a great offering like Luda. Now what does it take for a physical therapist to become a Luda practitioner and how does that benefit their current practice? Like is this something that they could do in conjunction with their clinic?

Yeah, home-based care isn't necessarily new. There has always been home health agencies. It's just that we weren't really supporting active population, or we weren't really supporting outpatient population, which is just how the business is structured, or the offering is structured. But the most important thing to think about as a therapist is how am I getting exposure to

different upcoming innovative solutions. For Luna, it was really important how our therapist experiences, because as clinicians, and this happens in all clinical world, as clinicians, we are doing a lot of administrative work, and we're doing a lot of clinical work, and we're doing everything. We're staying hours and hours after actually seeing our patients to get all of that stuff done. So at Luna, it was really important for us to make sure our therapists are able to stay focused on what they do best, which is patient care. In order for therapists, yes, so therapists can work at a clinic. In fact, all of more than 95% of therapists at Luna are moonlighting with Luna, hence the name Luna. So they're doing this for supplemental income, but there is a lot that goes into it to maintain

consistency in care. So yes, outpatient therapists, most of Luna therapists are three plus years of work experience. We actually have 10.5 years of average work experience of the therapists on the platform. We don't have new grads, we don't have students, we don't have physical therapy assistants. So if you are a licensed therapist without patient PT experience who can be successfully treating independently,

not being in a clinic environment, you're fit for Luna. Oh, now you mentioned paperwork, and I remember talking to you guys a little bit about that, like some of the benefits you provided in terms of lightening that load somehow, was that, like some of the benefits you provided in terms of lightening that load somehow, was that like? Yeah, PT's hate that. Yeah, it's like a lot of it.

It's like an hour of paperwork for each patient. Wow, that's a lot when it comes from, you know, personal training. We work with a lot of therapy. I'm sure you all have heard of, yeah. It's the PT's proving about that. But yes, burden of documentation is absolutely well-known. So that's what I think we did really well,

which is focus on the therapist experience. We recently did a stat where at Luna, we've developed this process called auto charting. It's twice enabled. So a therapist can actually finish a documentation in eight minutes versus 30 minutes that I did at a clinic, or three minutes for a standard visits where it would take me like 15, 20 minutes.

So it saved us a lot of time. And we recently did a look at it, and it was enough time to go to Mars and come back. So do you want to join that group? Do you want to be saving time and documentation and enjoying patient care? So therapists absolutely love it. So are they just speaking to the app?

Is that what it is? Yes, and to make anything simple, it goes a lot of work. So I don't want to undermine how not comprehensive. This is because it's a very comprehensive documentation system. But for a therapist, it's as simple as, OK, I have a visit with Adam. I'm going to come.

I'm going to start my session. So it starts actually geographically looking at where I am. It's making sure that you're actually at your patients home. I finish my session and then I'm driving to my next patient's visit. And I click a button. I get an interview.

I'm prompted questions. I answer those questions. And by the time I go home at night, I wake up the next morning. My chart's already ready for me. I can edit all of that and sign off on it. And the way we're also driving behavior is, as soon as you sign off on that chart, you're getting paid for that visit.

So you now don't have to wait for your two-week check to come in. You're actually getting paid as soon as you sign off. So in theory, could I do this as a... Could I be... Try... Pretending I'm a physical therapist, could I go to a patient's house and then set myself up to go to another patient's house on the way

from this patient's patient, I could be recording all that stuff. Can that be done? That can be done. And it only takes you eight minutes. So, or is it three minutes? Well, okay, so, you know, if I, so I'm gonna, from the PT's perspective, right?

So I normally work in a clinic, I see this new company. I like the fact that I could spend more time with my patient, but I got a drive. I'm going from person to person. Am I getting compensated for all this? Am I making more less as a competitive? Like, what does that look like for me as a therapist? It definitely has a higher earning potential to work with Luna

because we're paying by the visit. Wow. However, there is a difference in how outpatient gets reimbursed. And so, their Luna definitely pays therapists really well compared to a clinic. When you think about drive times, that's where Luna technology comes in. We're not really expecting our patients to, our therapists to spend an hour and a half to see one patient, right? So it's really important that their drive times are maintained within 30 minutes from one

patient to another. And that's where we increase the capacity and density of the patient population where they live. So they're not really driving back and forth across town or spending the entire day just seeing three or four patients. It's about how you leverage technology to restrict your time driving. How do you ensure you save time documentation so that you're not going home and then documenting and not getting paid for it?

How do you have an amazing administrative concierge team supporting you? So you're not now calling the doctors trying to figure out paperwork. So how do you solve that documentation burden, administrative burden, which really makes a sweet spot to get what you get paid for that visit for Luna Therapis? Well, isn't that like the secret sauce of Luna? Like I think I remember talking to Matt and don't you guys, didn't you guys acquire someone from Luna on the team? I mean, excuse me from Uber, who actually did all the geolocation and stuff. That is true. So our CTO is from Uber. And of course, he's a mastermind behind the matching and the routing.

So it's not just geographical location, but we're now looking at, is this therapist or orthopedie? Is this a neuro-pietie? Is this a vestibular pietie? What does a patient need? What is their time availability? Was the therapist time availability? What's their drive time going to be from one patient to another? Are they going to get back home without driving

45 minutes? So, so many amazing components. And of course, I think we have a really awesome CTO to do that for us. Okay, so everything you're explaining, right? So, you get someone to your house, which that's a big difference. People are going to adhere to it longer because of that. It's much more convenient. Therapists make more money, do less paperwork. I can't imagine something more disruptive to the market. Are people upset? Are you guys making other organizations upset or is this something that everybody's starting to adopt? Because I can't see how you would compete against that. What we want people to be upset. That means we're doing...

That was our goal, too, like that. Yeah, because we want them to not be super comfortable. You're never making innovation when it's something everybody can accept the very first time you see it. So it's okay. We're okay with people being upset. And it starts with at the most bottom level, right? When a therapist is referring a patient over to a personal trainer or a massage therapist and a massage therapist is sending a patient to a therapist,

you're always thinking, okay, am I gonna lose my patients? Am I going to have less patients in my clinic? Or if, you know, why wouldn't everybody want Luna? Absolutely, why wouldn't everybody want Luna? Absolutely. Why wouldn't everybody want Luna? There's a lot of questions that would arise. So there is definitely disruption because of that. But is it not challenging? It is very challenging to build what Luna has built. It's not an easy problem to solve.

So I think we have a lot of amazing support. We have a lot of amazing support from all the partners at Luna. We have health system partners. We have orthopedic group partners. We have individual lot of amazing support from all the partners at Luna. We have health system partners. We have orthopedic group partners. We have individual more than 2000 physicians who love Luna and refer to Luna today. So I think we need both. We need people who are upset and we need people who love us. So something that I've noticed a lot just, you know, being in the space, the health space for over two decades, I've noticed more than ever, children with posture deviations and pain,

I know kids, I read a statistic, I remember the exact percentage, but if you were a doctor, you probably, on 20 years ago, you rarely ever saw kids show up with chronic low back pain or neck pain. Now you're seeing that quite a bit. Do you guys also work with children for things like forward head and shoulder pain and back pain or neck pain. Now you're seeing that quite a bit. Do you guys also work with

children for things like forward head and shoulder pain and back pain? Is this starting to grow? Are you guys seeing more of this? You know, I think that's where it's the amazing thing, which is the potential and the opportunity is so huge. Luna sees patients from 13 to 103, right? So it sees the whole spectrum. We don't see patients below 13 years of age today. Could we, yes, we could, but our focus is 13 and over. And yes, I think that awareness, that education, athletic trainers, like coaches, all of those opportunities, where we identify, send these patients or send these children this population

to actually receive care sooner than later because they're sitting in front of the computers and then they're going and playing PE and soccer for like an hour. They have plasural deviations, they have forward head, they have lengthen nerves and they have lack of you know, phasic and tonic muscle balances. So how are we actually being proactive? Education's never gonna end. There's so much evidence, even though WHO identified that there's

underutilization of physical therapy. So how do we actually improve awareness amongst all of these people? So yes, we can absolutely see those kids. And we would love to see those kids because that's where you see the kids. It's a huge market because as a parent you got three kids, you got your child, you're like, man, his neck is not moving it right, he's got it

forward head, I can see some problems, he has a little bit, but I got to take him to the clinic and I got these other kids instead of being like just come to the house, I'm gonna be with the other kids over here, you guys do your thing, that's got to be like an exploding market, I would imagine. Yes, one of those exploding markets, but absolutely. Definitely a great opportunity. We have a lot of parents doing that. You will spend your ankle after a soccer practice. Don't procrastinate that. Don't just ice it. Take care of it. Let's figure out how to get it stronger because we want you to continue playing soccer. How do you do that?

So, the process would be instead of taking my kid to the doctor to have it look at, I could call you guys, tell you guys, listen, my kid, spraying their ankle, playing soccer, then we'd set up an appointment

and someone would come and do the initial assessment there. That is correct. Oh, wow, that makes it huge. And it'll be covered by your insurance. That makes a huge difference. Okay, so what kind of people then should seek out physical therapy?

Aside from the obvious, like, I had knee surgery or I've got major pain, like what are some areas that are common that maybe people aren't super aware of that they probably would benefit from physical therapy? Right. Well, I would say don't wait to be injured. If you're having aches and pains, you're having lack of ability to do what you want to do best. If you are a golfer, and if you can golf and your swing's not great If you're having aches and pains, you're having lack of ability to do what you want to do best. If you're a golfer, and if you can golf, and your swing's not great, and you're having some shoulder pain, see a physical therapist. If you're having low back pains,

sitting from working all day long, go see a physical therapist. If you're having neck pain, and which hasn't gone away for 10, 15 days, see a physical therapist. So the earlier you see a therapist, your prognosis is better. There's a higher chance you're gonna get better without needing x-rays and without needing medication and internally you always have this fear of wanting more medical care and paying for my insurance. I should get an x-ray, I should get an MRI, I should get this, I'm paying for this. I think we need to shift away from that and actually do something ourselves, take charge of our care.

And actually, even though it's not as easy as taking pills, we need to invest in our own body. You know what the irony of it is, is let's say you're listening and you're like, cool, I'm going to have a therapist come to my house and help me. So now my insurance is going to pay more. And the reality is insurance will end up saving money. And the long run because it's much cheaper to treat chronic low back pain through exercise than it is to have to do surgery later on.

So that's the irony, it's actually save money. You think you're saving everybody on both ends. That's what I'm saying, everybody saves money as a result of doing things right. So I have an uncle, I was having this conversation with him the other day, I'm like, we need to do some correctional exercise to like why I don't hurt. But I was watching him put on his shoes and he has to put them on really in a weird way.

He's got like, sit down and use his finger and he's got like a really bad movement. Like, we got to do some correctional exercise. Why? Who cares? I can still put my shoes on. Like, these are, these are simple things that I think you're not supposed to be sweating though and taking 15 minutes. Yeah. You don't have to take a break. Yeah, you shouldn't have to take a break. You should have to take a break, you should have to take a break, Uncle, from one shoe to the other shoe. But you know, or sitting down and having to twist your leg. Like, these are things that I think people don't realize that they could benefit from therapy.

Like, if you used to be able to put one sock on while standing and now you have to sit down because you're losing your balance or, you know, it's hard for you to tie your shoes or used to be able to reach up to the top of something and now you can't really reach it because you can't fully extend. Even though you may not feel pain, those people would benefit greatly. In fact, I would make the argument that those are the best people because it's before

they heard. Absolutely. And before they deteriorate or continue to stay away from things that they could be actually doing, saying independent, right? So today, we're able to put the shoe on, but tomorrow you actually might need a shoe hook. And the day after that, you actually might need a caregiver to help you with your shoe. So how could you actually not postpone that?

You mentioned something else just in passing about pelvic floor rehab. This one's really important to me now because I've dived a little deeper in this because my wife had a baby about 10 months ago and so many women Do not understand the symptoms of poor pelvic floor muscle strength especially after having a baby like it is so important that if you have a baby that you you do some type of pelvic floor exercise afterwards Otherwise you could end up with the chronic issue. I remember when I was a early trainer This one I was like 20 so imagine my shock when I had a client trying to jump in jacks No, I can't do them. Why?

I end up peeing myself a little bit. I was 20 years old. I'm like what? Yeah, that's okay. What the hell is going on here? like, how important is therapy post normal things? Like, I just had a baby. I think it's amazing. It's amazing. The more and more people know about this, it's great. So, thanks for asking that question, because it's very important to be just aware of your muscles, to be aware of how you could be doing things, how you could be compensating things. You're weak, so you bend a different way. You're not fully recovered, so you're actually lifting things wrongly or overloading your muscles. So I think it's really, really important after normal things like birthing that you're able to pay attention to yourself. And there is no way a newborn baby's mom is going to be able to go into a clinic. That's another amazing thing.

Just even six sessions of becoming more aware. How do you identify where your core is after giving childbirth? Or where are the small muscles in your sacrum and your lower back and your core stabilizers and re-engaging those in order to have that stability that holds your upper body and your lower body together, another exploding market like you were talking about. I think it's super underutilized because there hasn't been a convenient offering to have care like that. It's also a niche practice.

There are not as many pelvic floor therapists out there. So when you actually find a great pelvic floor therapist, pay attention to yourself. What about fitness enthusiasts? So somebody's listening, I'm like, I work out all time, I really fit. But I stopped deadlifting a while ago because it just tends to bother my back. So I don't do that anymore.

I just stop squatting. I do other leg exercises. I don't squat anymore because it bothers my knee. Are those people gonna benefit from working with a therapist? 100%. As I said, you know, as a trainer you might say, okay let's not do the sexercise because it's hurting, but as a therapist I might say let's figure out why you can't do the sexercise because if we're telling our patients don't do this then we're not doing our job because we need to figure out why

they're not able to do this and help them get back to that or help them navigate that. So one really good example is sciatica. What is sciatica? Sciatica is actually a symptom, but is the sciatica coming from your lower back? Is it coming from an impingement in your muscle or is it coming from like a nerve tension? You know, you need a physical therapist to help you guide to it so that now you're not hurting every time you bend and do a deadlift or you're bending over and coming up wrong. So if you have stayed away from a deadlift, you absolutely want to see your therapist because if you're so fit, figuring out where is that muscle imbalance would be perfect to help you get back to it. And you have a reason which is why you need skilled physical therapy.

Oh, excellent. So I have one last question for me, and it's a personal question. I'm just curious, because we didn't talk about this off-air there. Did Luna find you, or did you find Luna? And what was like the, I mean, you had been learning all this stuff

just like we are for the first time, and there was something that went, holy shit, I'm in, or whatever. Wow, that is a pretty personal question. But I think we found each other. Because like soulmates. Yes, I would 100% agree. I do get told at Luna often that I have purple blood in me.

So yes, I think it was perfect timing. I was at Stanford really enjoying. I grew a lot. I was co-lecturing for residency programs and I was, you know, a senior physical therapist getting trained in a lot of different innovative approaches to care. And you are in this feeling where I don't necessarily know it all. Am I, like, good enough?

But then it comes a point where you're like, okay, no, I do know a lot. I want to bring this to a larger number of people. And that's where when I met the CEO of Luna, the conversation was, am I a therapist at Luna? No, I think I definitely want to take a take on helping this at scale, bringing the quality at scale and leveraging technology to do this at scale. So I was in a transition of starting my own practice, and that could keep me limited to like five therapists,

10 therapists, a few different clinics, but doing this across 19 states, 32 markets, 1,200 therapists on the platform today has been an incredible opportunity. Excellent. So most, most big city metropolitan areas, would you say, is where people will have access? Yeah, if we go to getluna.com, there is our coverage map across the nation.

And we have a phone number. You can call Luna. You would get informed. If you have a therapist available in your market, we can verify your benefits before you start here. So there are no surprises on how much you actually pay a copay. A patient doesn't pay anything extra as compared to if they were to go to a clinic. So if you go to a clinic and $40 is your copayment, that would be your copayment. Wow. I predict this to explode unless there's some weird law that comes out to prevent, you know,

what you guys are doing, but I can't see this not completely taking over because there's absolutely no. The therapist makes more, they have to do less paperwork, the patient gets better care. So that means... Everybody wants. Yeah, that's why we wanted you on because this is exceptional. Very disrupting. I can't think of the last time I've felt like something, you know,

as established as PT got, is going to get this disrupted. So, very cool. That's really exciting to hear. And along with all the business side, as a clinician, I just feel there is a space for everything. There's a space for digitization of care, but there is a space where in-person care is going to help you solve your problem. And so, don't think that one thing can replace another.

Start taking care of yourself. If you need a PT in-home, there is an amazing opportunity like this for sure. Great. Thank you very much. Yeah. Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy and maximize your overall performance, check out our discounted RGB Superbundle at MindPump Media dot com.

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